Abstract 15987: Long-term Arrhythmia Recurrence in Elderly Women With Atrial Fibrillation
Introduction: After age 75, almost 60% of people with atrial fibrillation (AF) are women. Also the risk of stroke and death associated with AF is higher in women than men. Furthermore, the success rate of catheter ablation for AF is lower in women because of a high prevalence of non-pulmonary vein (non-PV) firings, non-paroxysmal AF and longer history of AF. Therefore, this study aimed to identify the predictors of AF recurrence in elderly women aged ≥75 years.
Methods: One hundred fifty-one women aged ≥75 years undergoing catheter ablation for AF were included in this analysis. During the initial procedure, all received isolation of PV and posterior wall; non-PV triggers were also ablated upon detection. These triggers were defined as ectopic triggers originating from sites other than pulmonary veins such as interatrial septum, superior vena cava, left atrial appendage (LAA), coronary sinus (CS), crista terminalis disclosed by incremental isoproterenol infusion. Patients were monitored for arrhythmia recurrence using event recorders, 7-day holters and ECGs. Repeat ablation was offered to all having recurrence.
Results: Mean age of the population was 77.9±2.6 years and 98 (65%) had non-paroxysmal AF. During the first procedure, LAA triggers were detected in 48 (31.8%) patients and were ablated. At 1 year of follow-up, 128 (84.7%) patients had recurrence, of which 126 opted to go for repeat ablation. Permanent PV and posterior wall isolation from previous ablation was observed in 108 of 126 patients (85.7%). Non-PV triggers were mostly mapped to LAA (95, 75.4%). Of the 95 patients demonstrating LAA triggers, 84 (88.4%) had triggers coming from new locations on LAA that were not detected during the first procedure.
Conclusions: In elderly women, new triggers from the left atrial appendage are frequently detected during repeat procedures and are responsible for recurrence after the standard procedure.
Author Disclosures: S. Mohanty: None. C. Trivedi: None. C. Gianni: None. R. Bai: None. A. Al-Ahmad: None. J. Burkhardt: None. J. Sanchez: None. R. Horton: None. G. Gallinghouse: None. R. Hongo: None. S. Beheiry: None. L. Di Biase: Speakers Bureau; Modest; Biotronik, EpiEP, Medtronic, Inc., Janssen Pharmaceuticals, Pfizer, Inc., Boston Scientific Corp.. Consultant/Advisory Board; Modest; Biosense Webster, Inc., St Jude Medical, Stereotaxis, Inc. A. Natale: Speakers Bureau; Modest; Boston Scientific Corp, Biotronik, Medtronic, Inc., Biosense Webster, Inc, St. Jude Medical. Consultant/Advisory Board; Modest; Janssen Pharmaceuticals, St. Jude Medical, Biosense Webster Inc..
- © 2016 by American Heart Association, Inc.